This project, the Colorado Associated Community Health Information Exchange (CACHIE), will design, develop, implement, and evaluate an interoperable quality information system (QIS) for a collaborative network of community health centers (CHC) that permits real-time and synchronous quality reporting to inform patient care, quality interventions, and health policy and advocacy efforts. The QIS will be foundational in nature, ultimately supporting many types of quality and safety analyses. The QIS will integrate data elements from various information systems (e.g., electronic health records (EHR), claims, and registries) to generate meaningful quality measures and reports at the patient, physician, practice, and population level. The QIS will support: 1) identification of best practices; 2) establishment of appropriate CHC benchmarks; 3) development, implementation, and evaluation of targeted quality improvement interventions, 4) use of clinical decision support systems, and 5) promotion of public policies to improve health and health services to low income populations. The initial chronic disease focus will be on diabetes mellitus in vulnerable rural and urban populations. [unreadable] [unreadable] [unreadable] [unreadable]